Scanning the news about concerns over explosion in medical imaging scans

In case you missed them, many stories reported on a new analysis of the explosion in the use of CT, MRI and other advanced imaging methods.

The Los Angeles Times: “Use of imaging tests soars, raising questions on radiation risk.”

Researchers looked at “data from patients enrolled in six large health maintenance organizations,” and “found that doctors ordered CT scans at a rate of 149 tests per 1,000 patients in 2010, nearly triple the rate of 52 scans per 1,000 patients in 1996.” Meanwhile, “MRI use nearly quadrupled during the period, jumping from 17 to 65 tests per 1,000 patients.”

The New York Times: “Radiation Concerns Rise With Patients’ Exposure.”

 ”The study, published in the Journal of the American Medical Association, says that while advanced medical imaging has undoubted benefits, allowing problems to be diagnosed earlier and more accurately, its value needs to be weighed against potential harms, which include a small cancer risk from the radiation.”

WebMD: “CT Scan Rates Tripled at HMOs in the Last 15 Years, Doubling Radiation Exposure to Patients”

Reuters:

The average radiation dose from a chest CT scan is 7 millisieverts, compared with 0.1 millisieverts for a typical chest X-ray, according to the American College of Radiology. But those levels can vary widely by machine, with some low-dose scanners delivering as little as 1.5 millisieverts for a chest CT, and some older machines delivering far higher doses.

Researchers say a radiation dose of 50 millisieverts starts to raise concerns about human health, and a dose of 100 millisieverts is thought to raise the risk of cancer.

MedPage Today: “Expanding indications, patient and physician demand, medical uncertainty, and defensive medicine likely all contributed to those trends.”

View the original article here

Examples of medical marketing for the week: full body skin cancer scans, robotic hysterectomy

Both of these were sent to me by journalists:

An email pitch letter from a medical group:

Medical Office has First Full Body Scanner to Protect Against Skin Cancer

Dear xxxxx,

We thought that this might make for a very interesting and informative article. With the approach of summer break, this is a time when most people head outdoors. It’s important for people to remember to protect their families against one of the most common forms of cancer today: skin cancer. Current statistics show that 1 in 5 Americans will develop skin cancer in their lifetime.

—- uses the latest technology to detect and protect against skin cancer. They are the only practice in central (could be any state) to offer this system which creates a digital map of the entire body.

Now let’s look at the evidence:  The US Preventive Services Task Force states that “the current evidence is insufficient to assess the balance of benefits and harms of using a whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population.”

The other example came from a journalist who wrote, “Doesn’t it seem particularly exploitative to use a 26-year-old woman’s hysterectomy for this?” The news release/pitch:

Surgeons at xxx Health Center have completed the first robot-assisted surgery in xxxx County.

The first patient was 26-year-old xxx, who underwent a robot-assisted hysterectomy April 13.

Hysterectomies and other gynecological procedures are the first of many robot-assisted surgical procedures that will be offered at xxx.

“We are proud to offer the most high-tech, minimally invasive treatment options available anywhere right here at xxx. Now our patients can benefit from the latest surgical technologies without leaving home,” says (the) president of xxx Health Center.

For advertising disguised as news, see this puff piece in the business section of The Tennessean online, “daVinci robot works miracles.” 

Addendum 5 hours later:  The Nashville Scene website reports, “Tennessean Farms Out Health Section to Hospital Flacks.“  And Paul Raeburn of the Knight Science Journalism Tracker writes:

“The changes come as the Tennessean institutes a paywall for many of its stories. (Newspaper management) said that because of the paywall, “The Tennessean will continue its mission of serving Middle Tennesseans for years to come.”

With regard to some things, maybe. But not with regard to health news. The paper has already failed in that mission.”

Finally, for absurdity in robot hype, see a Seattle doc’s You Tube video of how he used a robotic surgical system to fold a paper airplane – and see how the blogger known as The Skeptical Scalpel grounds that hype.

View the original article here